[0001] The present invention relates to a process for preparing a radiopharmaceutical composition.
More particularly, it relates to an improved process for preparing a radiopharmaceutical
composition comprising a technetium chelate complex suitable for diagnosis of renal
function.
[0002] Kidneys are important organs responsible for regulation of the compositions of body
fluids. Their fundamental constituting unit is called "nephron", and in case of human
kidneys, each kidney comprises about one million nephrons. The constancy of a body
fluid composition can be maintained by various functions of nephrons such as filtration,
passive secretion, active secretion, reabsorption, etc. When a kidney is damaged due
to any reason, those functions are lowered or stopped. For evaluation of the extent
and/or type of the damage in a kidney, various diagnostic methods for testing renal
functions have been diviced.
[0003] One of such renal function tests is known as a dynamic renal function imaging study.
This procedure has conventionally involved the intravenous injection of a radioactively
labeled iodine substance such as iodine-131 labeled orthoiodohippurate (hereinafter
referred to as "I-131-OIH"). After intravenous injection, I-131-OIH is effectively
removed from the blood by active tubular secretion in addition to glomerular filtration
at nephrons. As the result, the location and movement of the radiolabeled substance
can be detected and analyzed by a gamma-scintillation camera so that the renal function
becomes known. While the diagnosis with I-131-OIH is quite useful in evaluation of
renal function, it has some serious drawbacks.
[0004] First, the energy of gamma rays emitted from I-131 is so high as 364 keV (emission
rate, 81 %), and therefore the spatial resolution of an image obtained by a gamma-scintillation
camera is low. Because of this reason, the minute structure in a kidney is imaged
indefinitely, and the useful information are limited. Second, I-131 is a beta-ray
emitting nuclide, and the absorbed dose in the surrounding tissues is relatively large.
In particular, free I-131 accompanied with I-131-OIH is apt to be accumulated in a
thyroid gland so that the absorbed dose in the thyroid gland cannot be ignored. Because
of this reason, the maximum dose of I-131-OIH is limited to such a low dose as about
200 to 300 µCi. This low dose requires a considerable time of data collection for
obtaining an image by a gamma-scintillation camera, and the temporal resolution of
the sequential image as obtained during the examination of renal function is lowered.
[0005] As a radiolabeled substance overcoming the above drawbacks inherently present in
I-131-OIH, Fritzberg et al. proposed the use of technetium-99m labeled mercaptoacetylglycylglycylglycine
(hereinafter referred to as "Tc-99m-MAG3") (Fritzberg et al: J.Nucl.Med.,
27, 111-116 (1986)). Thereafter, Nosco et al. proposed an improved process for preparation
of Tc-99m-MAG3 (8th International Symposium on Radiopharmaceutical Chemistry, Abstract
(1990)). According to the proposal by Nosco et at., Tc-99m-MAG3 is prepared by adding
an aqueous solution of Tc-99m in the form of sodium pertechnetate to an aqueous solution
containing benzoylmercaptoacetylglycylglycylglycine, stannous chloride and sodium
tartrate, or its freeze-dried product, introducing air into the resultant mixture
to oxidize excessive stannous chloride and heating the resultant solution in a boiled
water bath for about 10 minutes.
[0006] The thus prepared Tc-99m-MAG3 is said to show substantially the same behavior in
vivo (e.g. active secretion into tubules) as I-131-OIH. Thus, the substantially same
information as given by I-131-OIH are obtainable by Tc-99m-MAG3 on the diagnosis of
renal function. Further, the energy of gamma-rays emitted by Tc-99m as the labeling
nuclide in Tc-99m-MAG3 is so low as 140 keV, and the spatial resolution of the image
obtained through a gamma-scintillation cameras is greatly improved in comparison with
that in case of I-131-OIH. Furthermore, Tc-99m emits only gamma-rays, and the absorbed
dose in the surrounding tissues is drastically reduced in comparison with I-131-OIH.
The maximum dose would be thus increased to about 100 times that of I-131-OIH. Such
high dose enables remarkable shortening of the data collection time on imaging by
the use of a gamma-scintillation camera, and as the result, the temporal resolution
of the sequential image as obtained during the examination on renal function is significantly
increased.
[0007] This Tc-99m-MAG3, however, requires such troublesome operations as heating and air
oxidation on its preparation, and physicians are unfavorably exposed to a great amount
of radiation. In order to avoid such exposure, the supply of Tc-99m-MAG3 as an injectable
radiopharmaceutical composition, i.e. in the form of a labeled preparation, is considered.
But, such supply necessitates the preparation of the infection using radioactivity
in an amount of about 10 times in comparison with the preparation by the physicians
at the diagnostic or clinical site, because a considerable time is needed for the
transportation. Further, the injectable radiopharmaceutical composition must have
a sufficient stability to retain a satisfactory radiochemical purity until its delivery
to the physicians.
[0008] In the examination of renal function, a rapid dynamic trace in early phase after
the administration is important, and for this purpose, the intravenous bolus injection
is usually requested. For the intravenous bolus injection, the use of a smaller liquid
amount is favorable, but Tc-99m-MAG3 as prepared by Nosco et at. only remains stable
for 6 hours after preparation when Tc-99m is used in an amount of not more than 100
mCi (8th International Symposium on Radiopharmaceutical Chemistry). In addition, it
is reported that in order to prevent decrease of the radiochemical purity, the labelling
should be effected in an amount of not less than 4 ml.
[0009] For the supply of Tc-99m-MAG3 in an injectable radiopharmaceutical composition, it
is thus necessary to provide a process wherein labelling can be effected with a larger
amount of radioactivity and which affords the product with excellent stability. It
is also necessary that the product is obtainable in a higher radiochemical purity
with a smaller liquid amount, i.e. in a higher radioactivity concentration.
[0010] As the result of an extensive study, it has now been found that an injectable radiopharmaceutical
composition comprising Tc-99m-MAG3 as prepared by a certain specific procedure overcomes
the drawbacks as stated above and is quite useful for examination of renal function.
The present invention is based on the above finding.
[0011] According to the present invention, a radiopharmaceutical composition comprising
Tc-99m-MAG3 is prepared by (1) mixing (a) HSCH₂CO-NHCH₂CO-NHCH₂CO-NHCH₂COOH (mercaptoacetylglycylglycylglycine,
MAG3), (b) a water-soluble reducing agent, (c) a water-soluble stabilizing agent in
an amount of not less than 70 mol per 1 mol of the water-soluble reducing agent and
(d) a Tc-99m pertechnetate at a pH of about 8 to 11 and (2) heating the resultant
mixture at a temperature of about 90 to 140°C.
[0012] One of the significant characteristics in the process of the invention is that MAG3
is used as such without protection of the terminal thiol group by any protective group
as benzoyl, which is essential in the processes of Fritzberg et al. and Nosco et at.
Another characteristic is that, different from the processes or Fritzberg et at. and
Nosco et at., the process of the invention uses a large amount of a water-soluble
stabilizer in the absence of an exchange ligand such as a citrate or a tartrate and
performs heating (usually about 90 to 140°C, preferably about 100 to 120°C) under
an alkaline condition.
[0013] The water-soluble reducing agent to be used in the invention may be any pharmaceutically
acceptable water-soluble reducing agent, and its preferred examples are primary tin
salts, i.e. divalent tin salts. Specific examples are stannous chloride, stannous
fluoride, stannous sulfate, stannous nitrate, stannous acetate, stannous citrate,
stannous tartrate, etc.
[0014] As the water-soluble stabilizer, there may be used ascorbic acid or erythrobic acid,
or any pharmaceutically acceptable salt or ester thereof. The amount of such stabilizer
is normally in an amount of not less than about 70 mol, preferably 100 mol, to 1 mol
of the reducing agent, although there is no upper limit to the amount of the stabilizer
insofar as any material toxicity or pharmacological effect is not exerted.
[0015] The radioactive diagnostic composition of the invention may be formulated in any
appropriate preparation form such as powder, lyophilized powder or solution. Further,
it may comprise, in addition to said essential components, any auxiliary agent such
as a pH regulating agent (e.g. acid, base), an isotonic agent (e.g. sodium chloride),
a preservative (e.g. benzyl alcohol) or the like.
[0016] Practical embodiments of the invention will be hereinafter explained in details by
way of examples.
Example 1
Preparation of a non-radioactive carrier composition:-
[0017] The following operations were all conducted in a stream of an inert gas (e.g. nitrogen,
argon) under sterile conditions.
[0018] Sterile and pyrogen free water was purged with an inert gas (e.g. argon) to remove
oxygen dissolved therein. Into 1000 ml of this water, sodium L-(+)-ascorbate and mercaptoacetylglycylglycylglycine
(MAG3) (658 mg) were dissolved, and anhydrous stannous chloride (57 mg) was added
thereto, followed by adjustment of pH with addition of aqueous sodium hydroxide solution.
The resultant solution having a sodium L-(+)ascorbate concentration of 0 to 80 mM
and a pH of 7.5 to 11.0 was filtered through a membrane filter (pore size, 0.22 µm),
and 0.5 ml each was filled in a vial. The aqueous composition was stored as such,
in a freezed state or in a freeze-dried state to use as a non-radioactive carrier
composition.
Example 2
Preparation of a radiopharmaceutical composition comprising Tc-99m-MAG3:-
[0019] The aqueous composition (0.5 ml) as obtained in Example 1 was mixed with a physiological
saline solution (1.5 ml) containing Tc-99m in the form of sodium pertechnetate. The
resultant mixture was stirred and heated in an autoclave at 120°C for 30 minutes,
followed by cooling to room temperature in a water bath to give a radiopharmaceutical
composition comprising Tc-99m-MAG3. With variation of the radioactivity of Tc-99m
in the physiological saline solution, there was obtained a radiopharmaceutical composition
containing Tc-99m-MAG3 of different radioactivity (5 to 130mCi on labeling).
Example 3
Analysis of a radiopharmaceutical composition comprising Tc-99m-MAG3:-
[0020] Analysis of Tc-99m-MAG3 may be carried out by the use of a chromatographic filter
paper obtained from Toyo Filter Paper Co., Ltd.
[0021] The radiopharmaceutical composition containing Tc-99m-MAG3 obtained in Example 2
was subjected to chromatography (filter paper: Toyo Filter Paper No. 51B; developing
solvent: acetonitrile/water = 70/30), and the following development was observed:
non-combined Tc-99m sodium pertechnetate, Rf = 0.9 to 1.0; Tc-99m tin colloid and/or
reduced hydrolyzed technetium such as TcO₂, Rf = 0; Tc-99m-MAG3, Rf = 0.4; complex
of impurities in MAG3 with Tc-99m or complex presumed as Tc-99m-(MAG3)₂, Rf = 0.25.
On the basis of this development, the radiochemical purity of Tc-99m-MAG3 may be calculated
according to the following equation:

Example 4
Effect of pH on preparation of a radiopharmaceutical composition comprising Tc-99m-MAG3:-
[0022] Using the non-radioactive carrier composition prepared as in Example 1, comprising
MAG3 (2.5 mM), ascorbic acid (75 mM) and stannous chloride (0.3 mM) and having a pH
of 7.5, 8.5, 9.5, 10.0, 10.5 or 11.0 and a physiological saline solution containing
5 mCi of Tc-99m in the form of sodium pertechnetate, there was prepared a radiopharmaceutical
composition comprising Tc-99m-MAG3 as in Example 2, which was then subjected to evaluation
of the radiochemical purity as in Example 3. The result are shown in Table 1.
[0023] The results in Table 1 show that Tc-99m-MAG3 having a higher radiochemical purity
is obtainable under alkaline condition and also that Tc-99m-MAG3 of a high radiochemical
purity is obtainable without a benzoyl protective group for the terminal thiol group
in the ligand MAG3, said benzoyl protective group having been taken as essential in
the method of Fritzberg et al method.
Table 1
Effect of pH on preparation of Tc-99m-MAH3:- |
pH |
7.5 |
8.5 |
9.5 |
10.0 |
10.5 |
11.0 |
Radiochemical purity (%) |
68.4 |
90.3 |
96.5 |
95.3 |
95.9 |
97.1 |
Example 5
Effect of ascorbic acid concentration on stability of a radioapharmaceutical composition
comprising Tc-99m-MAG3:-
[0024] Using the non-radioactive carrier composition prepared as in Example 1, comprising
MAG3 (2.5 mM), ascorbic acid (0, 5, 20, 40 or 80 mM) and stannous chloride (0.3 mM)
and having a pH of 10.5 and a physiological saline solution containing 130 mCi of
Tc-99m in the form of sodium pertechnetate, there was prepared a radiopharmaceutical
composition comprising Tc-99m-MAG3 as in Example 2, which was subjected to evaluation
of the radiochemical purity as in Example 3 immediately after the preparation and
after shaking at room temperature for 15 hours. The result are shown in Table 2.
[0025] The results in Table 2 show that a higher radiochemical purity of Tc-99m-MAG3 is
obtainable and can be retained over a long period of time when the molar ratio of
ascorbic acid to stannous chloride is about 70 or more.
[0026] Still, said shaking at room temperature for 15 hours is comparable to the normal
state of transportation from the preparation to the user or customer.

Example 6
Effect of heating on preparation of a radiopharmaceutical composition comprising Tc-99m-MAG3:-
[0027] Using the non-radioactive carrier composition prepared as in Example 1 (Sample No.
1, 2 or 3 as shown in Table 3) and a physiological saline solution containing 5 mCi
of Tc-99m in the form of sodium pertechnetate, there was prepared a radiopharmaceutical
composition comprising Tc-99m-MAG3 as in Example 2 (i.e. by heating). Likewise, using
the non-radioactive carrier composition prepared as in Example 1 (Sample No. 1', 2'
or 3' as shown in Table 3) and a physiological saline solution containing 5 mCi of
Tc-99m in the form of sodium pertechnetate, there was prepared a radiopharmaceutical
composition comprising Tc-99m-MAG3 by mixing said non-radioactive carrier composition
and said physiological saline solution together, stirring the resultant mixture and
allowing to stand at room temperature for 1 hour. The thus prepared radiopharmaceutical
composition was subjected to evaluation of the radiochemical purity as in Example
3. The results are shown in Table 4.
Table 3
Tc-99m-MAG3 used for evaluation |
Agent |
1 |
1' |
2 |
2' |
3 |
3' |
Concentration of MAG3 (mM) |
2.5 |
2.5 |
2.5 |
2.5 |
2.5 |
2.5 |
pH |
10.5 |
10.5 |
9.5 |
9.5 |
10.5 |
10.5 |
Concentration of stannous chloride (mM) |
0.3 |
0.3 |
0.3 |
0.3 |
0.3 |
0.3 |
Concentration of ascorbic acid (mM) |
0 |
0 |
75 |
75 |
75 |
75 |
Table 4
Effect of heating on preparation of Tc-99m-MAG3 |
Agent |
Heating |
Allowing to stand at room temperature |
|
1 |
2 |
3 |
1' |
2' |
3' |
Radiochemical purity (%) |
95.1 |
96.5 |
95.9 |
14.5 |
13.1 |
90.3 |
[0028] The results in Table 4 show that such a high radiochemical purity as 90 % can be
attained in the presence of ascorbate even allowed to stand at room temperature when
the pH is more than 10, but in order to attain a higher radiochemical purity, heating
is essential.
Example 7
Biodistribution of a radiopharmaceutical composition comprising Tc-99m-MAG3:-
[0029] Using the non-radioactive carrier composition prepared as in Example 1, comprising
MAG3 (2.5 mM), ascorbate (85 mM) and stannous chloride (0.17 mM) and having a pH of
10.5 and a physiological saline solution containing 10 mCi of Tc-99m in the form of
sodium pertechnetate, there was prepared a radiopharmaceutical diagnostic composition
comprising Tc-99m-MAG3 as in Example 2. Immediately after the preparation, the radiochemical
purity was determined in the manner as shown in Example 3 to be 98.3 %.
[0030] The radiopharmaceutical composition (0.2 ml) was administered to each of Sprague-Dawley
strain female rats by intravenous injection. After 15 minutes or 1 hour, the animal
was sacrificed, and the organis were taken out. The radioactivity of each organ was
determined, and the results are shown in Table 5.
[0031] As is clear from Table 5, Tc-99m-MAG3 prepared by the method of the invention is
rapidly excreted through the kidneys into urine. Tc-99m-MAG3 has thus an excellent
property suitable for diagnosis of renal function.

[0032] As understood from the above, Tc-99m-MAG3 useful as a diagnostic agent for renal
function can be prepared from mercaptoacetylglycylglycylglycine not having a benzoyl
protective group on the terminal thiol group without losing its excellent property.
It is notable that such preparation is possible even when a water-soluble stabilizing
agent is used in such a large amount as 70 mol or more to one mol of a water-soluble
reducing agent. It is also notable that the use of a water-soluble stabilizing agent
in such a large amount makes it possible to retain the stability over a long period
of time.
[0033] Accordingly, the present invention enables the supply of a radiopharmaceutical composition
comprising Tc-99m-MAG3 useful as a diagnostic agent for renal function to physicians
without any troublesome labeling operation at the diagnostic site. Therefore, physicians
can be relieved from the exposure to radiation during the labeling operation. Further,
this invention makes it possible to mininize the liquid amount of the injection to
be administered to 2 ml or less. Administration of such small amount is quite favorable
for diagnosis of renal function, which usually requires rapid intravenous bolus injection.